Individual provider Active NPI

Therese Ann Moreno, PLMSW

  • Clinical Social Worker
  • Albuquerque, NM
National Provider Identifier
1477071611
Registry record updated May 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C-11743 Issued in NM
Practice address
912 1St St NW
Albuquerque, NM 87102-2355
Phone
(505) 224-9777
Fax
(505) 244-9779
NPI assigned
Sep 8, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 29, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X X10178 NM
Clinical Social Worker 1041C0700X C-11743 NM Primary

Addresses

Primary practice location

912 1St St NW
Albuquerque, NM 87102-2355

Mailing address

912 1St St NW
Albuquerque, NM 87102-2355
Phone (505) 224-9777

Other practice location 1

1625 Rio Bravo Blvd SW Ste 36
Albuquerque, NM 87105-6060
Phone (505) 777-3004

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230921002169 NM Practitioner - Clinical Social Worker 3678927878 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mended House CounselingGroup PAC ID 9638567647, 2 clinicians

Practice addresses (Care Compare)

3916 Augusta Dr SE
Rio Rancho, NM 87124-8246
Phone (505) 903-9510

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
C-11743NMMDClinical Social Worker
X10178NMMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Duke City Recovery Toolbox LLC Current Accepting new patients
Duke City Recovery Toolbox LLC CurrentSince Sep 1, 2023 Accepting new patients
Mended House Counseling CurrentSince Jul 27, 2025 Accepting new patients

Locations

912 1st St NW
Albuquerque, NM 87102
Phone (505) 224-9777

1909 29th St SE
Ste D
Rio Rancho, NM 87124

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1504828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748476800000",
    "number": "1477071611",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "912 1ST ST NW",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871022355",
            "telephone_number": "505-224-9777",
            "fax_number": "505-244-9779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "912 1ST ST NW",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871022355",
            "telephone_number": "505-224-9777",
            "fax_number": "505-244-9779"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1625 Rio Bravo Blvd SW Ste 36",
            "address_purpose": "LOCATION",
            "city": "Albuquerque",
            "state": "NM",
            "postal_code": "871056060",
            "country_code": "US",
            "telephone_number": "505-777-3004",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MORENO",
        "first_name": "THERESE",
        "middle_name": "ANN",
        "credential": "PLMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-08",
        "last_updated": "2025-05-29",
        "certification_date": "2025-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NM",
            "license": "X10178",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NM",
            "license": "C-11743",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

Verify at the official NPI Registry.